Microvascular Ischemic Disease

Overview

Microvascular ischemic disease is a term that’s used to describe changes to the small blood vessels in the brain. Changes to these vessels can damage white matter — the brain tissue that contains nerve fibers and serves as the connection point to other parts of the brain.

Small vessel ischemic disease is in older adults. If left untreated, it can contribute to mental decline, strokes, walking and balance problems, and dementia.

Symptoms

Microvascular ischemic disease can be mild, moderate, or severe.

Many older adults — especially those with a mild form of the disease — have no symptoms, even though there are areas of damage in the brain. This is called “silent” disease. In one study, up to of healthy elderly people had silent damage in their brain, most of which was caused by small vessel disease.

Even though you might not notice any symptoms, you may have subtle changes in your thinking and physical abilities.

Causes and risk factors

The cause of microvascular ischemic disease isn’t completely understood. It can be the result of plaque buildup and hardening (atherosclerosis) that damages the small blood vessels nourishing the brain. This is the same process that narrows and damages blood vessels to the heart and can lead to heart attacks.

Damage can block blood flow through the blood vessels in the brain, depriving brain cells (neurons) of oxygen. Or, it can cause blood vessels in the brain to leak and bleed, which can damage neighboring neurons.

Treatment options

Treatment generally involves managing the risk factors that contribute to small blood vessel damage in the brain. Which treatment strategy your doctor recommends will depend on your specific risk factors, but it might include:

Lowering your blood pressure with diet, exercise, weight loss, and medication. The goal for people age 60 and over is a systolic blood pressure (the top number) .

Outlook

Ischemic small-vessel disease can be very serious, leading to stroke, dementia, and death if it isn’t treated. It causes about of dementia cases and 20 percent of strokes.

The best way to avoid these complications is to prevent small blood vessel damage in the first place. Follow a healthy diet, exercise regularly, and take the medication your doctor recommends to control your blood pressure and cholesterol levels.